When hyperthyroidism develops in a patient currently receiving a medication known to be associated with thyroid overactivity, evaluation of the causative drug becomes the first step in management.
Clinical scenario: Hyperthyroidism occurring in the context of an agent associated with the condition — including lithium, interferon alfa, a tyrosine kinase inhibitor, or highly active antiretroviral therapy (HAART). This form of hyperthyroidism is generally self-limited.
Management involves a targeted review of the implicated medication — specifically whether it can be safely modified in this patient. The complete structured regimen provides the clinical framework for that decision and the steps that follow.